Spinal Disorders

Question 1

What causes radicular pain?

Answer 1

inflammation or medullary compression of the dorsal root

Question 2

What are the symptoms of a transection or transverse myelopathy?

Answer 2

LMN signs and level of sensory loss localize to the spinal level of the lesion

UMN signs develop in limb muscles innervated by anterior horn cells below the level of the lesion

Acute, severe traumatic lesion may present with spinal shock (UMN signs development delay)

Question 3

What is the etiology of a transection/transverse myelopathy

Answer 3

Trauma, inflammation (viral, MS, autoimmune), compression, ischemia

Question 4

What are the symptoms of a syrinx/syringomyelia?

Answer 4

initial suspended (vest-like) spinalthalamic sensory loss with sacral sparing.

Cavity may then disrupt anterior horn cells and cause paraparesis if corticospinal tract is involved

Position and vibration sense are spared

Question 5

What is the etiology of a syrinx?

Answer 5

Abnormal CSF flow or pressure with congenital (Chiari) malformation
Tumor
Residual of a tumor

Question 6

What are the symptoms of an occlusion of the anterior spinal artery?

Answer 6

sudden hyperreflexic, spastic paraparesis, loss of pain/temp below the lesion

• preserved dorsal column pathway

Question 7

What are the etiologies of an occlusion of the anterior spinal artery?

Answer 7

athersclerotic aortic disease or dissection

aortic surgery

Question 8

What is another name for subacute combined degeneration?

Answer 8

Posterolateral syndrome

Question 9

What are the symptoms of subacute combined degeneration?

Answer 9

loss of vibration sense but preserved pain/temperature

UMN signs in lower limbs

Question 10

Name three things that can lead to subacute combined degeneration

Answer 10

Vitamin B12 deficiency (most common)
HIV
copper deficiency

Question 11

What are common presenting symptoms of ALS?

Answer 11

Combination of UMN and LMN signs-

LMN are initially asymmetrical, with gradually more generalized LMN signs with diffuse fasciculations (–> severe atrophy of muscles)

Question 12

What is the etiology of ALS?

Answer 12

Etiology unknown.

Question 13

What are the symptoms of tabes dorsalis?

Answer 13

Shooting lightning pains from initial dorsal root lesions –> subsequent dorsal column pathway involvement –> eventual loss of all sensation

Areflexia

preserved strength (no UMN or LMN involvement)

Question 14

What is the etiology of tabes dorsalis?

Answer 14

syphilis

Question 15

What are the symptoms of a brown-sequard lesions?

Answer 15

Contralateral pain/temperature sensation

Ipsilateral weakness/loss of proprioception/vibration

Question 16

What are the etiologies of a brown-sequard lesion?

Answer 16

Extramedullary: tumors,
trauma
herniated disc